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Unusual case of bilateral maxillary fungus ball
  1. Alessandro Vinciguerra,
  2. Alberto Maria Saibene,
  3. Paolo Lozza,
  4. Alberto Maccari
  1. Otolaryngology Department, ASST Santi Paolo e Carlo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
  1. Correspondence to Professor Alberto Maccari, bmjotorinosanpaolo{at}


An otherwise healthy 34-year-old man was referred to our ear, nose and throat (ENT) clinic for a bilateral maxillary radiologic opacity. This condition was accidentally discovered with a panoramic radiography performed during a follow-up visit after a bilateral endodontic treatment. The patient did not report any specific sinonasal symptom such as purulent nasal discharge, loss of smell and cough, apart from an unspecific sinus pressure. The CT scans showed a bilateral inflammatory process into the maxillary-ethmoidal sinuses and an iron-like density within the maxillary sinuses, while nasal endoscopy showed purulent discharge in the ostiomeatal complex. The patient underwent functional endoscopic sinus surgery under general anaesthesia and the inflammatory material collected was histologically diagnosed as a rare case of bilateral fungus ball. The patient was dismissed the following day with no complications; there were not any sign of recurrence or symptoms during a 4 month follow-up.

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  • Contributors AM made substantial contribution to the concept and design of the work; AV took part in the analysis and interpretation of data; PL participated in drafting the article and revising it critically and AMS gave the final approval of the version to be submitted.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.